| NPI | 1174516470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TP0814X Psychologist, Psychoanalysis (Licence: FL PY3898) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY3898) |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2011-10-10 |