NPI | 1497069215 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY25206) |
Additional Taxonomies | 103K00000X Behavior Analyst |
Enumeration Date | 2010-08-04 |
Last Update Date | 2016-06-08 |