| NPI | 1487498838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY33474) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071010851) |
| Enumeration Date | 2024-06-20 |
| Last Update Date | 2025-07-17 |