| NPI | 1407063530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: DE B1-0000501) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: IL 071-004156) |
| 103TC1900X Psychologist, Counseling (Licence: MD 3572) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2007-07-08 |