| NPI | 1023184694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071005343) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IN 20042090a) |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2021-03-20 |