NPI | 1578598462 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IL 071-004240) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071-004240) |
103TR0400X Psychologist, Rehabilitation (Licence: IL 071-004240) | |
Enumeration Date | 2006-07-11 |
Last Update Date | 2007-07-08 |