| NPI | 1952385148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071-006876) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IN 20041693A) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2016-05-31 |