| NPI | 1235359399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TP2701X Psychologist, Group Psychotherapy (Licence: IL 149004359) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149004359) |
| Enumeration Date | 2007-04-30 |
| Last Update Date | 2007-07-08 |