| NPI | 1700856614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: IL 071-004781) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: IL 071004781) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2018-12-17 |