| NPI | 1811290257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: CA AFE24041) |
| Additional Taxonomies | 102L00000X Psychoanalyst (Licence: CA AFE24041) |
| Enumeration Date | 2010-12-07 |
| Last Update Date | 2010-12-07 |