| NPI | 1225165327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NJ 03781) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 012226) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2007-07-08 |