| NPI | 1851518617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: IL 036078553) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036-078553) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036078553) | |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2021-03-11 |