| NPI | 1396913927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071007616) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178005415) |
| Enumeration Date | 2008-02-17 |
| Last Update Date | 2009-01-27 |