NPI | 1467505800 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: NJ 35SI00344400) |
Additional Taxonomies | 103T00000X Psychologist (Licence: NY 012999) |
Enumeration Date | 2007-01-19 |
Last Update Date | 2007-07-24 |