| NPI | 1952361610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 93-00292) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036.147764) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 1160) | |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2023-03-07 |