| NPI | 1013478932 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036175160)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036175160)  | 
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: IL 036175160)  | |
| Enumeration Date | 2019-03-26 | 
| Last Update Date | 2025-08-14 |