| NPI | 1619977808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NJ 35S100217600) |
| Additional Taxonomies | 103TP0814X Psychologist, Psychoanalysis (Licence: NJ 35S100217600) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2008-02-28 |