| NPI | 1831540111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 036.153420) |
| Additional Taxonomies | 2084N0600X (Licence: IL 036.153420) |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2022-10-24 |