NPI | 1245451905 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071-006146) |
Additional Taxonomies | 103T00000X Psychologist (Licence: IL 071.006146) |
Enumeration Date | 2007-05-01 |
Last Update Date | 2022-02-28 |