| NPI | 1467469429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NM 0877) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NM 1-16-22964) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2016-10-18 |