| NPI | 1033439435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: ME 1-06-3004) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: ME PS698) |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2010-06-08 |