| NPI | 1396797213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TA0700X Psychologist, Adult Development & Aging (Licence: IL 071-003895) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: IL 071-003895) |
| 103TC0700X Psychologist, Clinical (Licence: IL 071-003895) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IL 071-003895) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: IL 071-003895) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2007-07-08 |