NPI | 1932275401 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS008549L) |
Additional Taxonomies | 103TP0814X Psychologist, Psychoanalysis (Licence: PA PS008549L) |
103T00000X Psychologist (Licence: PA PS008549L) | |
Enumeration Date | 2006-11-28 |
Last Update Date | 2010-07-21 |