| NPI | 1568507135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TP0814X Psychologist Psychoanalysis |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: WA MD00015377) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2007-07-08 |