| NPI | 1972502110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071-003074) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WI 1489-057) |
| 103T00000X Psychologist (Licence: IL 071003074) | |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2024-03-26 |