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 |