| NPI | 1497767669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IL 071005952) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: IL 071005952) |
| 103TC0700X Psychologist, Clinical (Licence: IL 071005952) | |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2021-11-09 |