| NPI | 1407362189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IL 71006089) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY8865) |
| Enumeration Date | 2017-12-18 |
| Last Update Date | 2021-07-01 |