NPI | 1467801449 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MA 489092) |
Additional Taxonomies | 104100000X Social Worker (Licence: MA 300468) |
Enumeration Date | 2016-06-09 |
Last Update Date | 2016-06-09 |