NPI | 1669696753 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY25372) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: IL 071007085) |
2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 071007085) | |
Enumeration Date | 2007-04-12 |
Last Update Date | 2023-11-27 |