| NPI | 1629773478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178020309) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: IL KELL-GLU4KJ) | |
| Enumeration Date | 2023-04-03 |
| Last Update Date | 2024-11-01 |