NPI | 1063471027 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071-004107) |
Additional Taxonomies | 103T00000X Psychologist (Licence: IL 071004107) |
Enumeration Date | 2006-03-20 |
Last Update Date | 2021-04-26 |