| NPI | 1679522536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071-006046) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071006046) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2018-11-13 |