| NPI | 1881889483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY 4627) |
| Additional Taxonomies | 103TP0814X Psychologist, Psychoanalysis (Licence: FL PY 4627) |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2011-01-24 |