| NPI | 1881631927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NJ 35SI00485900) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: IL 071006705) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2018-06-05 |