| NPI | 1013369578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071010052) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IL 071010052) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IL 071010052) | |
| Enumeration Date | 2016-07-08 |
| Last Update Date | 2022-04-06 |