| 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 |