| NPI | 1104018050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IL 036103961) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: IL 036103961) |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2021-07-29 |