| NPI | 1053302422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036091849) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 917320) |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2026-05-08 |