| NPI | 1851742100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NV 22363) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 307546) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036164788) | |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2024-06-17 |