| NPI | 1124022678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TF0000X Psychologist, Family (Licence: NJ 35SI00384100) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: NJ 00069899) |
| 106H00000X Marriage & Family Therapist (Licence: NJ 37FI00158000) | |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2009-11-14 |