| NPI | 1053445833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NJ 01057) |
| Additional Taxonomies | 103TF0000X Psychologist, Family (Licence: NJ 01057) |
| 106H00000X Marriage & Family Therapist (Licence: NJ 01057) | |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2007-07-08 |