| NPI | 1619009875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036068860) |
| Additional Taxonomies | 174400000X Specialist (Licence: IL 36-068860) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2018-04-30 |