| NPI | 1952431819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 009502) |
| Additional Taxonomies | 103TF0000X Psychologist Family (Licence: NY 009502) |
| 103TP0814X Psychologist Psychoanalysis (Licence: NY 009502) | |
| 106H00000X Marriage & Family Therapist (Licence: NY 009502) | |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: NY 009502) | |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2010-08-24 |