| NPI | 1457725210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: VA 0133001133) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: VA 0134000131) |
| Enumeration Date | 2015-11-17 |
| Last Update Date | 2018-05-03 |