| NPI | 1316943582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 1961) |
| Additional Taxonomies | 103TP0814X Psychologist, Psychoanalysis |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2014-09-24 |