| NPI | 1508135625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: AR 88-12EI) |
| Additional Taxonomies | 102L00000X Psychoanalyst (Licence: AR 88-12EI) |
| Enumeration Date | 2011-12-19 |
| Last Update Date | 2020-04-21 |