| NPI | 1285169094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071003833) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IL 166000417) |
| Enumeration Date | 2017-04-30 |
| Last Update Date | 2017-04-30 |