| NPI | 1700071651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TN 86) |
| Additional Taxonomies | 103TM1800X Psychologist, Intellectual & Developmental Disabilities |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2018-03-17 |