| NPI | 1467675322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 003977) |
| Additional Taxonomies | 102L00000X Psychoanalyst (Licence: NY 000789) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2007-07-08 |