| NPI | 1700116399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY7726) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: AZ BA-273) |
| 103K00000X Behavior Analyst (Licence: CA 1-10-6815) | |
| 103T00000X Psychologist (Licence: MN LP5323) | |
| 103T00000X Psychologist (Licence: NM 1048) | |
| Enumeration Date | 2010-01-05 |
| Last Update Date | 2021-11-30 |