| NPI | 1487860144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: SD 407) |
| Additional Taxonomies | 102L00000X Psychoanalyst (Licence: SD 407) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2018-04-20 |