| NPI | 1922111657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 27862) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G85401) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036.151063) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2026-09-14 |