| NPI | 1427431816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-18-32555) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 0-14-6352) |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2020-09-05 |