| NPI | 1831156868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0805X Psychiatry & Neurology Geriatric Psychiatry (Licence: MO 118361) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IL 36097254) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2021-01-12 |