NPI | 1780077362 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NJ 35S100280400) |
103TF0200X Psychologist, Forensic | |
Enumeration Date | 2015-03-06 |
Last Update Date | 2015-03-06 |