| NPI | 1194031203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA 17654) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IL 071.005036) |
| Enumeration Date | 2010-08-26 |
| Last Update Date | 2024-09-12 |