| 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 |