| NPI | 1881716272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 102L00000X Psychoanalyst (Licence: NY 000070) |
| Additional Taxonomies | 102L00000X Psychoanalyst (Licence: VT 098000101) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2012-02-23 |