NPI | 1992918809 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: NY 013810-1) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NY 013810-1) |
Enumeration Date | 2007-05-07 |
Last Update Date | 2007-07-08 |