| NPI | 1033091947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TS0200X Psychologist, School (Licence: IL 2725368) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: AZ 5149128) |
| Enumeration Date | 2025-07-22 |
| Last Update Date | 2025-07-22 |