| NPI | 1598214165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: OH UK685720) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: OH UK685720) |
| Enumeration Date | 2016-09-23 |
| Last Update Date | 2016-09-23 |