| NPI | 1831329531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036135813) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR LL18239) |
| Enumeration Date | 2009-07-16 |
| Last Update Date | 2014-08-19 |