| NPI | 1922357268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180001866) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KS 2526) |
| Enumeration Date | 2012-08-31 |
| Last Update Date | 2024-10-17 |