| NPI | 1427331966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071010244) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 2013044732) |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2024-02-28 |