| NPI | 1548309206 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: IL 149002280)  | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149002280)  | 
| Enumeration Date | 2007-02-06 | 
| Last Update Date | 2025-09-11 |