| NPI | 1487045712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 246ZE0600X Specialist/Technologist, Other Electroneurodiagnostic |
| Enumeration Date | 2015-02-09 |
| Last Update Date | 2015-07-20 |