| NPI | 1548791650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20043350B) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst |
| 103TC0700X Psychologist, Clinical (Licence: IN 20043350A) | |
| 103TC0700X Psychologist, Clinical (Licence: IL 071010236) | |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2020-06-11 |