| NPI | 1427454636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-15-18144) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 74661) |
| Enumeration Date | 2014-11-15 |
| Last Update Date | 2015-04-01 |