NPI | 1235189887 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071-002747) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IN 20040730A) |
Enumeration Date | 2006-05-12 |
Last Update Date | 2007-07-08 |