| NPI | 1902178015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IL 071008293) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071008293) |
| 103TA0700X Psychologist, Adult Development & Aging | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 103TC1900X Psychologist, Counseling | |
| 103TR0400X Psychologist, Rehabilitation | |
| 103TF0200X Psychologist, Forensic (Licence: IL 071008293) | |
| Enumeration Date | 2012-02-04 |
| Last Update Date | 2012-04-09 |