| NPI | 1528151909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WI 2477) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IL 71006826) |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2022-07-21 |