| NPI | 1750393237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME109325) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036092506) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 86855) | |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2021-11-02 |