| NPI | 1114190949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036125453) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036.125453) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI 14761) | |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2021-06-28 |