| NPI | 1073684643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071007224) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AZ 4703) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2024-03-27 |