| NPI | 1285872895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY 22311) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 1084607) |
| Enumeration Date | 2009-02-04 |
| Last Update Date | 2009-02-04 |