| NPI | 1386741460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WA PY00000548) |
| Additional Taxonomies | 103TP0814X Psychologist, Psychoanalysis (Licence: WA PY00000548) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2007-08-14 |