| NPI | 1194892539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TP0814X Psychologist, Psychoanalysis (Licence: WA PY00001916) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WA PY00001916) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2010-02-04 |