| NPI | 1811148786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036.125774) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: DC 149789) |
| Enumeration Date | 2008-10-09 |
| Last Update Date | 2021-04-07 |