| NPI | 1790092179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY0004093) |
| Additional Taxonomies | 103TP0814X Psychologist, Psychoanalysis (Licence: FL PY0004093) |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: FL PY0004093) | |
| 106H00000X Marriage & Family Therapist (Licence: FL PY0004093) | |
| Enumeration Date | 2010-09-08 |
| Last Update Date | 2024-08-26 |