| NPI | 1942400072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036138542) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2011-00818) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2011-00818) | |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2021-02-04 |