| NPI | 1467766923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TH0004X Psychologist Health (Licence: IL 071008470) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: VA 0810005758) |
| 103TC0700X Psychologist Clinical (Licence: AZ 4313) | |
| 103TC0700X Psychologist Clinical (Licence: IL 071008470) | |
| Enumeration Date | 2010-07-27 |
| Last Update Date | 2024-04-17 |