| NPI | 1023250230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: AZ BA-14) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 1-08-4598) |
| Enumeration Date | 2009-04-02 |
| Last Update Date | 2012-04-11 |