| NPI | 1508997792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NV PY1013) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IL 071007205) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2021-05-28 |