| NPI | 1477841187 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NC 1-11-8870)  | 
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MD 1-11-8870)  | 
| 103K00000X Behavior Analyst (Licence: FL 1-11-8870)  | |
| Enumeration Date | 2011-07-14 | 
| Last Update Date | 2022-12-20 |