| NPI | 1730233966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI JP035054) |
| Additional Taxonomies | 102L00000X Psychoanalyst (Licence: MI 4301035054) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2007-07-08 |