| NPI | 1972125615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071011105) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KS 3256) |
| Enumeration Date | 2020-05-16 |
| Last Update Date | 2023-11-22 |