| NPI | 1841588407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05395700) |
| Additional Taxonomies | 102L00000X Psychoanalyst (Licence: NJ 44SC05395700) |
| 102L00000X Psychoanalyst (Licence: NY 078092-1) | |
| 1041C0700X Social Worker, Clinical (Licence: NY 078092-1) | |
| Enumeration Date | 2011-07-18 |
| Last Update Date | 2011-07-18 |