| NPI | 1467832873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NY 918394151) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NY 613543122) |
| 103K00000X Behavior Analyst (Licence: NY 464755101) | |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2015-06-02 |