| NPI | 1750500682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 102L00000X Psychoanalyst (Licence: NY 000373) |
| Additional Taxonomies | 103TP0814X Psychologist, Psychoanalysis (Licence: PA PS002047L) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2007-07-08 |