| NPI | 1841426665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 021285) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NY 000065-1) |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2015-11-30 |