| NPI | 1962994269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: DC LGPC00397) |
| Additional Taxonomies | 102L00000X Psychoanalyst (Licence: 06158139) |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2018-06-01 |