| NPI | 1003049966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036135221) |
| Additional Taxonomies | 103TP0016X Psychologist, Prescribing (Medical) (Licence: IL 036.135221) |
| Enumeration Date | 2009-08-26 |
| Last Update Date | 2019-08-28 |