| NPI | 1497820377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IL 071001707) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071001707) |
| 103T00000X Psychologist (Licence: IL 071001707) | |
| 103TF0200X Psychologist, Forensic (Licence: IL 071001707) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: IL 071001707) | |
| Enumeration Date | 2006-11-23 |
| Last Update Date | 2007-07-08 |