| NPI | 1427021823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 1586) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 1-11-8160) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2022-12-26 |