| NPI | 1578279667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 102L00000X Psychoanalyst (Licence: ZZ 83931635791) |
| Additional Taxonomies | 174400000X Specialist (Licence: ZZ 2176058) |
| Enumeration Date | 2023-01-23 |
| Last Update Date | 2025-06-25 |