| NPI | 1346333713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IL 071-007914) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WI 2624) |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2015-09-01 |