| NPI | 1225087752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IL 036-103040) |
| Additional Taxonomies | 2084P0805X Psychiatry & Neurology Geriatric Psychiatry (Licence: IL 036-103040) |
| 208D00000X General Practice (Licence: IL 036-103040) | |
| 2084A0401X Psychiatry & Neurology Addiction Medicine (Licence: IL 36-103040) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2017-02-10 |