| NPI | 1295309326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071010972) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IL 178009612) |
| Enumeration Date | 2021-05-13 |
| Last Update Date | 2023-05-10 |