| NPI | 1225516933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: IL 1225516933) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 1225516933) |
| Enumeration Date | 2018-08-03 |
| Last Update Date | 2025-06-09 |