| NPI | 1952993362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TS0200X Psychologist, School |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: NY 2953249) |
| Enumeration Date | 2021-02-07 |
| Last Update Date | 2021-02-07 |