| NPI | 1992232144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: VA 0101274542) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: IL 036173178) |
| Enumeration Date | 2017-05-18 |
| Last Update Date | 2025-04-14 |