| NPI | 1881910081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: IL 036132941) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2010011165) |
| 208D00000X General Practice (Licence: MO 2012008167) | |
| 208D00000X General Practice (Licence: IL 036132941) | |
| Enumeration Date | 2010-04-13 |
| Last Update Date | 2015-05-15 |