NPI | 1720579691 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IL 071.009799) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071.009799) |
Enumeration Date | 2018-05-25 |
Last Update Date | 2021-12-28 |