| NPI | 1558579755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036150134) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX M5857) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 162599) | |
| Enumeration Date | 2007-05-19 |
| Last Update Date | 2020-11-10 |