| NPI | 1366849325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 277000413) |
| Additional Taxonomies | 367A00000X Advanced Practice Midwife (Licence: IL 277.000413) |
| Enumeration Date | 2014-11-19 |
| Last Update Date | 2024-08-08 |