| NPI | 1881683969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071003666) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IL 166000210) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2007-09-18 |