| NPI | 1487711511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IL 071.009362) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA 17341) |
| Enumeration Date | 2007-01-01 |
| Last Update Date | 2016-12-09 |