| NPI | 1316763428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY P132128) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TP0814X Psychologist, Psychoanalysis | |
| Enumeration Date | 2024-11-25 |
| Last Update Date | 2024-11-25 |