| NPI | 1912229691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: DC PSY309) |
| Additional Taxonomies | 103TA0700X Psychologist Adult Development & Aging (Licence: DC PSY309) |
| 103TP0814X Psychologist Psychoanalysis (Licence: DC PSY309) | |
| Enumeration Date | 2010-02-22 |
| Last Update Date | 2010-02-22 |