| NPI | 1467775486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY27102) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 01-06-2707) |
| Enumeration Date | 2010-03-04 |
| Last Update Date | 2015-04-14 |