| NPI | 1447455910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 4062) |
| Additional Taxonomies | 103TP0814X Psychologist, Psychoanalysis (Licence: OR 1696) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2025-10-14 |