| NPI | 1700893443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TP0814X Psychologist Psychoanalysis (Licence: FL ME0058630) |
| Additional Taxonomies | 102L00000X Psychoanalyst |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2008-09-25 |