| NPI | 1306282223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CT 629) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 670387121) |
| Enumeration Date | 2013-05-18 |
| Last Update Date | 2019-09-04 |