| NPI | 1265592463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NY 347) |
| Additional Taxonomies | 102L00000X Psychoanalyst (Licence: NY 587) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2011-03-07 |