| NPI | 1174785810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 20A11315) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 20A11315) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2010-09-02 |