| NPI | 1053658377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IL 071.008614) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AZ 4350) |
| Enumeration Date | 2013-01-07 |
| Last Update Date | 2013-08-15 |