| NPI | 1467862144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036.159958) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 29089) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NE 29089) | |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2022-05-15 |