| NPI | 1255439659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TA0700X Psychologist, Adult Development & Aging |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 013016) |
| 103TC1900X Psychologist, Counseling | |
| 103TF0200X Psychologist, Forensic | |
| 103TP0814X Psychologist, Psychoanalysis | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2007-07-09 |