NPI | 1114213642 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-01-0382) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: KY 003) |
Enumeration Date | 2011-06-23 |
Last Update Date | 2018-09-13 |