| NPI | 1629553748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: IL A-2256-0001-A) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: IL A-2256-0001-A) |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2018-10-22 |