| NPI | 1306373345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MA 1998) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MA 1-17-25640) |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2017-06-28 |