| NPI | 1821489097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036.147145) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 125068293) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-02-10 |
| Last Update Date | 2020-07-24 |