| NPI | 1124284708 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: IL 036-127321)  | 
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 125-054734)  | 
| Enumeration Date | 2008-08-02 | 
| Last Update Date | 2020-09-15 |