| NPI | 1750552071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY R-050461) |
| Additional Taxonomies | 102L00000X Psychoanalyst (Licence: NY R-050461) |
| Enumeration Date | 2008-03-13 |
| Last Update Date | 2024-04-10 |