NPI | 1659421212 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071005918) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: IL 071005918) |
103T00000X Psychologist (Licence: IL 071005918) | |
103TH0004X Psychologist, Health (Licence: IL 071005918) | |
Enumeration Date | 2007-01-12 |
Last Update Date | 2022-04-06 |