| NPI | 1134364409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 1-09-6455) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 0-04-1385) |
| Enumeration Date | 2008-12-15 |
| Last Update Date | 2012-01-20 |