NPI | 1104976976 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 102L00000X Psychoanalyst (Licence: CA RP277) |
Additional Taxonomies | 101Y00000X Counselor (Licence: none) |
102L00000X Psychoanalyst (Licence: CA RPS277) | |
Enumeration Date | 2007-01-11 |
Last Update Date | 2024-08-22 |