NPI | 1376732255 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: IL 071007352) |
Additional Taxonomies | 103TH0004X Psychologist, Health (Licence: IL 071007352) |
Enumeration Date | 2007-10-17 |
Last Update Date | 2021-05-14 |