NPI | 1811907835 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 102L00000X Psychoanalyst |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PA 000021) |
101YM0800X Counselor, Mental Health (Licence: NJ 37PC00345100) | |
101YM0800X Counselor, Mental Health (Licence: PA PA000021) | |
Enumeration Date | 2006-08-09 |
Last Update Date | 2014-10-17 |