| NPI | 1659594778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TP0814X Psychologist, Psychoanalysis (Licence: PA 4478L) |
| Additional Taxonomies | 102L00000X Psychoanalyst (Licence: NY 000800) |
| 103TP0814X Psychologist, Psychoanalysis (Licence: NY 01025) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2019-11-01 |