| NPI | 1578726253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IL 036130036) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology Addiction Psychiatry (Licence: IL 036130036) |
| 2084P0802X Psychiatry & Neurology Addiction Psychiatry (Licence: NV 13267) | |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2020-12-02 |