| NPI | 1215339932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: IL 071008646) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: IL 049144667) |
| Enumeration Date | 2014-09-25 |
| Last Update Date | 2014-09-25 |