NPI | 1558342220 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036090369) |
Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: IL 036090369) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 5101020205) | |
Enumeration Date | 2005-11-09 |
Last Update Date | 2022-11-17 |