| NPI | 1730201567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036-086358) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036-086358) |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: IL 036-086358) | |
| 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: IL 036-086358) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: IL 036086358) | |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2024-10-03 |