| NPI | 1720344526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036138017) |
| Additional Taxonomies | 2084P0805X (Licence: IL 036138017) |
| Enumeration Date | 2012-04-05 |
| Last Update Date | 2017-12-29 |