| NPI | 1427430651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: IL 036.149899) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA L-262986) |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2019-07-01 |