| NPI | 1104923408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071008271) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180003279) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2011-12-12 |