| NPI | 1285988295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA Psy33023) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 103TF0200X Psychologist, Forensic (Licence: CA Psy33023) | |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2022-12-20 |