| NPI | 1043435340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: IL 036-046-108) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036-046-108) |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: IL 036-046-108) | |
| 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: IL 036-046-108) | |
| 2080P0008X Pediatrics, Neurodevelopmental Disabilities (Licence: IL 036-046-108) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036-046-108) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: IL 036-046-108) | |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2016-10-12 |