| NPI | 1609108703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: IL 074.000011) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071.007831) |
| Enumeration Date | 2010-02-01 |
| Last Update Date | 2021-12-15 |