| NPI | 1033297312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NJ TP-023-291) |
| Additional Taxonomies | 225C00000X Rehabilitation Counselor (Licence: NJ 37RC0086300) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2007-07-08 |