| NPI | 1568971091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071010014) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: GA PSY004131) |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2023-01-31 |