| NPI | 1821965591 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NJ 253-085) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NJ 253-085) |
| 103TC0700X Psychologist, Clinical (Licence: NJ 253-085) | |
| Enumeration Date | 2025-10-18 |
| Last Update Date | 2025-10-18 |