| NPI | 1659831501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036165319) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: 90200000x) |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2024-11-19 |