| NPI | 1215045315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KS 494) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KS 494) |
| 103TP0814X Psychologist, Psychoanalysis (Licence: KS 494) | |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2020-01-10 |