| NPI | 1770594897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036.130183) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01038899A) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 25942) | |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2017-04-20 |