| NPI | 1801060397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: MI 4301100465) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: IL 036128448) |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2013-03-07 |