| NPI | 1003043142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL B 5020) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: FL B 5020) |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2009-06-16 |