| NPI | 1740368430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IL 071-006306) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: IL 071-006306) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: IL 071-006306) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: IL 071-006306) | |
| 103TC0700X Psychologist, Clinical (Licence: IL 071-006306) | |
| 103K00000X Behavior Analyst (Licence: IL 071-006306) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2017-02-24 |