| NPI | 1689029027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI MD-21100) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL AM3582269-653) |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2021-06-29 |