| NPI | 1578962890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IL 071.022430) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CO PSY.0004274) |
| 103G00000X Clinical Neuropsychologist (Licence: CO PSY.0004274) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IL 071.022430) | |
| 103K00000X Behavior Analyst | |
| Enumeration Date | 2014-08-22 |
| Last Update Date | 2026-03-12 |