| NPI | 1669759981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071-008222) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: IL 071-008222) |
| 103T00000X Psychologist (Licence: IL 071-008222) | |
| Enumeration Date | 2011-11-15 |
| Last Update Date | 2021-11-22 |