NPI | 1730507013 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TF0200X Psychologist, Forensic (Licence: NY 20016) |
Additional Taxonomies | 103TF0200X Psychologist, Forensic (Licence: NJ 5237) |
Enumeration Date | 2014-04-02 |
Last Update Date | 2014-04-02 |