| NPI | 1205443975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IL 071.010550) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IA 100313) |
| Enumeration Date | 2020-09-28 |
| Last Update Date | 2024-11-21 |