| NPI | 1558426924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IL 071-002647) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: IL 071-002647) |
| 103TF0200X Psychologist, Forensic (Licence: IL 071-2647) | |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2007-07-09 |