| NPI | 1982639803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: NC 0852) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: IL 072002957) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2012-08-27 |