| NPI | 1538560198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071.010980) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IN 20042974A) |
| Enumeration Date | 2014-09-12 |
| Last Update Date | 2023-09-04 |