| NPI | 1346752821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-18-30819) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: TX 8736) |
| Enumeration Date | 2017-10-24 |
| Last Update Date | 2018-06-26 |