| NPI | 1083759344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036127291) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 5101016964) |
| 2084P0805X (Licence: IL 036-127291) | |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2021-05-03 |