| NPI | 1174920474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: IL 036-039477) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: IL 037-039477) |
| Enumeration Date | 2014-12-02 |
| Last Update Date | 2014-12-02 |