| NPI | 1144660572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: IL 036150593) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: MA 270964) |
| Enumeration Date | 2013-06-29 |
| Last Update Date | 2019-12-04 |