| NPI | 1407098254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MO 2012014239) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: IL 1-04-1745) |
| Enumeration Date | 2009-03-25 |
| Last Update Date | 2013-02-18 |