| NPI | 1730409368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TF0200X Psychologist, Forensic (Licence: IL 071.006877) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IL 071.006877) |
| 103TC0700X Psychologist, Clinical (Licence: IL 071.006877) | |
| 103TH0100X Psychologist, Health Service (Licence: IL 071.006877) | |
| Enumeration Date | 2010-06-05 |
| Last Update Date | 2010-06-05 |