NPI | 1063406569 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: IL 164-2611) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: IL 71-5240) |
103G00000X Clinical Neuropsychologist (Licence: IN 20040961A) | |
Enumeration Date | 2005-09-12 |
Last Update Date | 2008-10-27 |