| NPI | 1023521200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071.010003) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IL 071.010003) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IL 071.010003) | |
| 103TF0000X Psychologist, Family (Licence: IL 071.010003) | |
| 103TH0100X Psychologist, Health Service (Licence: IL 071.010003) | |
| Enumeration Date | 2017-11-10 |
| Last Update Date | 2023-02-27 |