| NPI | 1235486168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-10-7493) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 1107493) |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2019-03-18 |