| NPI | 1437731692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 102L00000X Psychoanalyst (Licence: NY 000807) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 547315) |
| Enumeration Date | 2021-04-26 |
| Last Update Date | 2021-04-26 |