| NPI | 1053524900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 9320) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 9320) |
| 103TF0000X Psychologist, Family (Licence: NY 9320) | |
| 103TP0814X Psychologist, Psychoanalysis (Licence: NY 9320) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: NY 9320) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2008-03-10 |