| NPI | 1265567879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180005026) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC0700X Psychologist, Clinical (Licence: IL 071007523) | |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2024-04-17 |