| NPI | 1528489481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 4666) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NC 01-13-14687) |
| Enumeration Date | 2013-12-19 |
| Last Update Date | 2026-07-09 |