| NPI | 1578709176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: RI 425) |
| Additional Taxonomies | 103TP0814X Psychologist, Psychoanalysis (Licence: RI 425) |
| Enumeration Date | 2009-01-02 |
| Last Update Date | 2012-03-02 |