| NPI | 1689897639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: IL 074-000010) |
| Additional Taxonomies | 103TP0016X Psychologist, Prescribing (Medical) (Licence: IL 374-000010) |
| 103TC0700X Psychologist, Clinical (Licence: IL 071-007153) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2025-02-19 |