| NPI | 1215325568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-18-29158) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL b653168903610) |
| Enumeration Date | 2015-01-08 |
| Last Update Date | 2020-04-10 |