| NPI | 1063398238 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071.022302) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IN 20043979B) |
| Enumeration Date | 2025-08-13 |
| Last Update Date | 2025-08-13 |