| NPI | 1467556589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071006063) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WI 2384057) |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2010-12-10 |