| NPI | 1447866355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 106915-01) |
| Additional Taxonomies | 103TP2701X Psychologist, Group Psychotherapy (Licence: AL 2290) |
| 103T00000X Psychologist (Licence: AL 2290) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: AL 2290) | |
| 103TC0700X Psychologist, Clinical (Licence: AL 2290) | |
| 103TC0700X Psychologist, Clinical (Licence: NY 017776) | |
| 103TC1900X Psychologist, Counseling (Licence: AL 2290) | |
| 103TF0000X Psychologist, Family (Licence: AL 2290) | |
| 103TP0814X Psychologist, Psychoanalysis (Licence: AL 2290) | |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2025-01-02 |