| NPI | 1669508933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 0030591) |
| Additional Taxonomies | 103TP0814X Psychologist, Psychoanalysis |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2007-07-08 |