| NPI | 1629292305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IL 071-006875) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IL 071.006875) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2019-03-20 |