| NPI | 1346747441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MD F622108051787) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2018-04-06 |