| NPI | 1558113175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 102L00000X Psychoanalyst (Licence: NY 750) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 1799) |
| Enumeration Date | 2024-04-05 |
| Last Update Date | 2024-04-05 |