| NPI | 1295184760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 102L00000X Psychoanalyst (Licence: CA RP-48) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CA RP-48) |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2016-06-06 |