| NPI | 1326197484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WI 2018) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IL 71005752) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2007-07-08 |