| NPI | 1932247491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 4) |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service (Licence: MA 4) |
| 103TP0814X Psychologist, Psychoanalysis (Licence: MA 4) | |
| 103T00000X Psychologist (Licence: MA 4) | |
| Enumeration Date | 2007-02-04 |
| Last Update Date | 2007-07-08 |