| 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 |