| NPI | 1174599757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY 8900) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2024-01-31 |