| NPI | 1558741322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: RI PS01235) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IL 071.009007) |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2015-06-05 |