| NPI | 1124251673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 004295-1) |
| Additional Taxonomies | 102L00000X Psychoanalyst (Licence: NY 000845-1) |
| Enumeration Date | 2009-09-01 |
| Last Update Date | 2009-09-01 |