| NPI | 1174884514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071.009392) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IN 20042890A) |
| Enumeration Date | 2012-06-01 |
| Last Update Date | 2017-03-31 |