| NPI | 1982616876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071-010363) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 180003385) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2023-05-26 |