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 |