| NPI | 1831237510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NJ 35S100297000) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NJ 35S100297000) |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: NJ 35S100297000) | |
| 103TC1900X Psychologist Counseling (Licence: NJ 35S100297000) | |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2024-05-14 |