| NPI | 1386682144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IL 036-108787) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036-108787) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2017-05-03 |