| NPI | 1083131999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085006687) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA PA6238) |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2019-04-24 |