| NPI | 1497094718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NY 112093) |
| Additional Taxonomies | 102L00000X Psychoanalyst (Licence: NY 112093) |
| Enumeration Date | 2013-02-06 |
| Last Update Date | 2016-11-03 |