| NPI | 1801821954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TF0000X Psychologist, Family (Licence: NJ 2759) |
| Additional Taxonomies | 103TF0000X Psychologist, Family (Licence: NY 08919) |
| 103TP0814X Psychologist, Psychoanalysis (Licence: NJ 2759) | |
| 103TP0814X Psychologist, Psychoanalysis (Licence: NY 08919) | |
| 103T00000X Psychologist (Licence: NY 08919) | |
| 103T00000X Psychologist (Licence: NJ 2759) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2007-07-08 |