| NPI | 1093159451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: AL 1-15-19295) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: AL wxr-01058632) |
| 103TS0200X Psychologist, School | |
| Enumeration Date | 2013-04-29 |
| Last Update Date | 2023-11-30 |