| NPI | 1154553287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-07-3242) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: FL ss739) |
| Enumeration Date | 2009-08-24 |
| Last Update Date | 2009-08-24 |