| NPI | 1023251113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-11-86655) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 0-06-2165) |
| Enumeration Date | 2009-04-20 |
| Last Update Date | 2014-02-20 |