| NPI | 1104475912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071022235) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2019-09-05 |
| Last Update Date | 2026-01-27 |