| NPI | 1255393039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071-004138) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IL 166-000355) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2007-07-08 |