| NPI | 1932333770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IL 071.008489) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178.006067) |
| Enumeration Date | 2009-05-07 |
| Last Update Date | 2016-03-02 |