| NPI | 1578896890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: DC PRC14002) |
| Additional Taxonomies | 102L00000X Psychoanalyst (Licence: DC Advanced candidate) |
| Enumeration Date | 2009-09-18 |
| Last Update Date | 2009-09-18 |