| NPI | 1881015790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NY 022429) |
| Additional Taxonomies | 103TP0814X Psychologist Psychoanalysis |
| 103T00000X Psychologist | |
| 103TB0200X Psychologist Cognitive & Behavioral | |
| 102L00000X Psychoanalyst | |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| 103TF0000X Psychologist Family | |
| Enumeration Date | 2013-12-18 |
| Last Update Date | 2017-10-27 |