| NPI | 1851439103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA02601500) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NJ 25MA02601500) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2014-03-14 |