| NPI | 1750344404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: IL 036-059563) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: MI 4301084933) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2025-08-03 |