| NPI | 1417251901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: PA 190003377) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NJ 1-08-4290) |
| Enumeration Date | 2010-12-27 |
| Last Update Date | 2023-01-13 |