| NPI | 1073931036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 125-064763) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125064763) |
| Enumeration Date | 2014-04-06 |
| Last Update Date | 2021-11-02 |