| NPI | 1053467258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071005287) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IL 071005287) |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| Enumeration Date | 2007-01-28 |
| Last Update Date | 2023-07-14 |