| NPI | 1902004203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2017030250) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2007012480) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036-126918) | |
| Enumeration Date | 2007-07-07 |
| Last Update Date | 2023-04-04 |