| NPI | 1992704225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IL 071005584) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WI 1957-057) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2007-07-08 |