| NPI | 1093790776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071-006835) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180-005185) |
| 103T00000X Psychologist (Licence: IL 071-006835) | |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2011-03-08 |