| NPI | 1306068416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TP0814X Psychologist, Psychoanalysis (Licence: FL py3885) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY3885) |
| 103TC0700X Psychologist, Clinical (Licence: FL PY3885) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2025-09-11 |