| NPI | 1265743314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: RI 1-16-24040) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 0-09-3696) |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2023-10-11 |