| NPI | 1528260940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071007474) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY 21461) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2008-05-21 |