| NPI | 1841387834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NJ 37FI00158900) |
| Additional Taxonomies | 102L00000X Psychoanalyst (Licence: NY 000637) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2007-07-08 |