| NPI | 1558626267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IL 071.008376) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: IL 071008376) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: IL 071008376) | |
| 103TF0200X Psychologist Forensic (Licence: IL 071.008376) | |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2024-05-07 |