| NPI | 1053568766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IL 036-126565) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125053711) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IL 125053711) | |
| Enumeration Date | 2008-08-25 |
| Last Update Date | 2011-11-16 |