| NPI | 1427382902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NJ 35SI00494800) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 018802) |
| Enumeration Date | 2009-09-30 |
| Last Update Date | 2013-05-24 |