NPI | 1053054783 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IL 071.010786) |
Additional Taxonomies | 103T00000X Psychologist (Licence: IL 071.010786) |
103G00000X Clinical Neuropsychologist | |
103TC0700X Psychologist, Clinical (Licence: IL 071.010786) | |
Enumeration Date | 2022-04-20 |
Last Update Date | 2022-09-15 |