| NPI | 1487883872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AK 177756) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 102L00000X Psychoanalyst (Licence: WA RC60092186) | |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2025-01-15 |