| NPI | 1306068416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY3885) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: FL PY3885) |
| 103TP0814X Psychologist Psychoanalysis (Licence: FL PY3885) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2007-07-08 |