NPI | 1356460984 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IL 071.004166) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071.004166) |
Enumeration Date | 2007-03-28 |
Last Update Date | 2007-07-08 |