| NPI | 1568654473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY R0311021) |
| Additional Taxonomies | 102L00000X Psychoanalyst (Licence: NY 000429) |
| 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05908200) | |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2024-01-18 |