| NPI | 1255344628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: IL 071-003024) |
| Additional Taxonomies | 103TR0400X Psychologist, Rehabilitation (Licence: IL 071-003024) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2016-08-07 |