| NPI | 1447263041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071-007269) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180-004243) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2011-11-04 |