NPI | 1609643519 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: IL 071011118) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
Enumeration Date | 2023-12-11 |
Last Update Date | 2024-11-10 |