NPI | 1033540240 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071-008681) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 020083) |
Enumeration Date | 2013-12-13 |
Last Update Date | 2013-12-13 |