| NPI | 1700904562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 071005264) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071005264) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2026-08-10 |