NPI | 1518183177 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IL 071-003149) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071-003149) |
103TF0200X Psychologist, Forensic (Licence: IL 071-003149) | |
Enumeration Date | 2007-04-18 |
Last Update Date | 2007-07-08 |