NPI | 1932148541 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TP2701X Psychologist, Group Psychotherapy |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 2714) |
103TF0000X Psychologist, Family | |
103TF0200X Psychologist, Forensic | |
103TP0814X Psychologist, Psychoanalysis | |
103T00000X Psychologist (Licence: MA 2714) | |
Enumeration Date | 2006-06-06 |
Last Update Date | 2025-09-11 |