| NPI | 1407939473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KY 130799) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: KY 271776) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2025-10-16 |