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 |