| NPI | 1447376348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP0569) |
| Additional Taxonomies | 103TP0814X Psychologist, Psychoanalysis (Licence: MN LP0569) |
| 103T00000X Psychologist (Licence: MN LP0569) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2009-02-07 |