| NPI | 1093267478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NH 1506) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071009402) |
| Enumeration Date | 2016-11-01 |
| Last Update Date | 2022-09-08 |