| NPI | 1003992413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IL 036036185) |
| Additional Taxonomies | 174400000X Specialist (Licence: IL 036036185) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2018-04-20 |