| NPI | 1811420276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: IL 036.155076) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: IL 036.155076) | |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2023-07-02 |