NPI | 1053527580 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NJ 35S100121400) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NJ 35S100121400) |
Enumeration Date | 2007-05-14 |
Last Update Date | 2007-07-08 |