| NPI | 1467753061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TN 1-10-7831) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: VA 0133000030) |
| Enumeration Date | 2010-11-12 |
| Last Update Date | 2017-04-14 |