| NPI | 1710289590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071008046) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IL 071008046) |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: IL 071008046) | |
| Enumeration Date | 2010-11-29 |
| Last Update Date | 2021-06-09 |