| NPI | 1174065700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: WA 61151781) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 11210465) |
| Enumeration Date | 2016-11-14 |
| Last Update Date | 2021-09-02 |