NPI | 1649339573 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071003796) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IN 20040076A) |
Enumeration Date | 2006-12-06 |
Last Update Date | 2007-07-08 |