| NPI | 1518259092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036137132) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2019-02460) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101265416) | |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2021-09-15 |