| NPI | 1871907774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2024-00787) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: IL 036143215) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036143215) | |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2025-08-25 |