NPI | 1740440981 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: NJ SI 02653) |
Additional Taxonomies | 103T00000X Psychologist (Licence: NY 00088891) |
Enumeration Date | 2008-06-11 |
Last Update Date | 2008-06-11 |