NPI | 1932100369 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 102L00000X Psychoanalyst (Licence: MI 43010-28241) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 43010-28241) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 43010-28241) | |
103TF0000X Psychologist, Family (Licence: MI 43010-28241) | |
103TP0814X Psychologist, Psychoanalysis (Licence: MI 43010-28241) | |
102L00000X Psychoanalyst (Licence: MI 4301028241) | |
103TA0700X Psychologist, Adult Development & Aging (Licence: MI 43010-28242) | |
Enumeration Date | 2005-08-09 |
Last Update Date | 2023-02-18 |