NPI | 1356771083 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: ZZ IL-2013399) |
Additional Taxonomies | 101Y00000X Counselor |
103TP0814X Psychologist, Psychoanalysis (Licence: IL-2013399) | |
1041C0700X Social Worker, Clinical | |
Enumeration Date | 2013-11-15 |
Last Update Date | 2019-06-11 |