| NPI | 1649302167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TB0200X Psychologist Cognitive & Behavioral (Licence: IL 71005294) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IL 71005294) |
| Enumeration Date | 2007-03-10 |
| Last Update Date | 2020-06-03 |