| NPI | 1538605134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301019120) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071009453) |
| 103T00000X Psychologist (Licence: IL 071009453) | |
| Enumeration Date | 2017-01-06 |
| Last Update Date | 2025-09-24 |