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 |