| NPI | 1134446602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MO 00029) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IL 071.002161) |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2010-04-23 |