| NPI | 1104161256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-13-14045) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CO 1-13-14045) |
| Enumeration Date | 2012-11-30 |
| Last Update Date | 2024-07-18 |