| NPI | 1235560517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CO 11312974) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MA 11312974) |
| Enumeration Date | 2013-12-11 |
| Last Update Date | 2020-04-20 |