| NPI | 1457436446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NJ 1-08-4742) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: NJ 35SI00626400) |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: NE 633) | |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2022-04-26 |