| NPI | 1144588914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY8522) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL PY8522) |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2026-05-06 |