| NPI | 1134228802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 2711-057) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071-002790) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2018-06-14 |