| NPI | 1497866172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071004135) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071-004135) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2012-12-26 |