| NPI | 1013924281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NJ 35S100286300) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 0111941) |
| 103TC0700X Psychologist, Clinical (Licence: PA PS015502) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2007-07-08 |