| NPI | 1164786448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AR E-9482) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036-166085) |
| Enumeration Date | 2012-07-01 |
| Last Update Date | 2023-12-14 |