NPI | 1043366297 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071-001939) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: IL 071-001939) |
103TH0100X Psychologist, Health Service (Licence: IL 071-001939) | |
Enumeration Date | 2007-01-28 |
Last Update Date | 2008-11-13 |