| NPI | 1710678438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 125.082225) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.082225) |
| Enumeration Date | 2023-05-15 |
| Last Update Date | 2024-06-20 |