| NPI | 1750454203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TP0814X Psychologist, Psychoanalysis (Licence: NY 188) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 1937) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2025-09-28 |