| NPI | 1396146833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036137817) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA09515600) |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2018-05-30 |