| NPI | 1346464922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071002701) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
| 103TF0200X Psychologist, Forensic | |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2007-07-08 |