| NPI | 1306280516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071006239) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IN 20041586A) |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2013-04-18 |