| NPI | 1689701211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CO 45536) |
| Additional Taxonomies | 102L00000X Psychoanalyst (Licence: CO 45536) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2024-10-22 |