| NPI | 1497747513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071-002872) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IL 071-002872) |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: IL 071-002872) | |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2015-01-19 |