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 |