| NPI | 1053642199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: KS 1-09-5896) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: AL 1-09-5896) |
| Enumeration Date | 2010-01-28 |
| Last Update Date | 2014-09-15 |