| NPI | 1134411721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CO 1-17-25948) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 0-06-2126) |
| Enumeration Date | 2011-05-14 |
| Last Update Date | 2017-07-06 |