NPI | 1891703435 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: MO PYR0188) |
Additional Taxonomies | 103T00000X Psychologist (Licence: IL 071004835) |
Enumeration Date | 2006-08-03 |
Last Update Date | 2007-07-08 |