NPI | 1306984380 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: NJ 35S100437300) |
Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NJ 35S100437300) |
Enumeration Date | 2007-02-02 |
Last Update Date | 2007-07-08 |