| NPI | 1669458063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IA 223) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IL 711856) |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2007-07-08 |