| NPI | 1508831512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: NY 9531NY) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: NY 9154PA) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2013-02-22 |