| 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 |