| NPI | 1114069093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071-003853) |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service (Licence: IL 071-003853) |
| 103T00000X Psychologist (Licence: IL 071-003853) | |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2007-07-08 |