| NPI | 1942392212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036078386) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 1048-320) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A46687) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2024-03-21 |