| NPI | 1649309113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036-090433) |
| Additional Taxonomies | 2084P0805X (Licence: IL 036-090433) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2008-03-21 |