| NPI | 1205075397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: HI PSY-350) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IL PSY-350) |
| Enumeration Date | 2009-02-12 |
| Last Update Date | 2021-06-11 |