| NPI | 1699142091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071009274) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: DC PSY1001016) |
| Enumeration Date | 2015-09-01 |
| Last Update Date | 2021-09-08 |