| NPI | 1790671022 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 125086174) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125086174) |
| Enumeration Date | 2025-06-13 |
| Last Update Date | 2025-06-13 |