| NPI | 1710425319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IL 071009462) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: IL 071009462) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: IL 071009462) | |
| 103TF0000X Psychologist Family (Licence: IL 071009462) | |
| Enumeration Date | 2017-02-03 |
| Last Update Date | 2024-04-30 |