NPI | 1689712234 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: NJ F100940) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NJ F100940) |
103TC1900X Psychologist, Counseling (Licence: NJ F100940) | |
103TF0000X Psychologist, Family (Licence: NJ F100940) | |
Enumeration Date | 2007-02-02 |
Last Update Date | 2007-07-08 |