| NPI | 1174837132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-99-0177) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 1-99-0177) |
| 103T00000X Psychologist (Licence: CA PSY8876) | |
| Enumeration Date | 2010-08-02 |
| Last Update Date | 2013-01-23 |