NPI | 1326266610 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY R051279) |
Additional Taxonomies | 102L00000X Psychoanalyst (Licence: NY 000600) |
Enumeration Date | 2007-04-23 |
Last Update Date | 2009-09-22 |