NPI | 1699781310 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036-108963) |
Additional Taxonomies | 174400000X Specialist (Licence: IL 036-108963) |
Enumeration Date | 2006-08-01 |
Last Update Date | 2021-07-21 |