NPI | 1083354641 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071.010665) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: IL 071.010665) |
103T00000X Psychologist (Licence: IL 071.010665) | |
Enumeration Date | 2022-03-31 |
Last Update Date | 2024-05-27 |