| NPI | 1821018227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TF0000X Psychologist, Family (Licence: NJ 35 SI 00263700) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NJ FI 070400) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2007-07-08 |