| NPI | 1336453265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071007942) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: IL 071007942) |
| 103TH0004X Psychologist, Health (Licence: IL 071007942) | |
| Enumeration Date | 2010-08-03 |
| Last Update Date | 2011-12-22 |