| NPI | 1760265292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 00000000) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: GA 000000) |
| Enumeration Date | 2023-08-17 |
| Last Update Date | 2025-06-18 |