| NPI | 1982763702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 016676) |
| Additional Taxonomies | 103TP0814X Psychologist, Psychoanalysis (Licence: NY 016676) |
| 103T00000X Psychologist (Licence: NY 016676) | |
| Enumeration Date | 2006-12-07 |
| Last Update Date | 2007-07-08 |