| NPI | 1487951992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-10-7931) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NV LBAT041511) |
| Enumeration Date | 2011-02-17 |
| Last Update Date | 2011-05-24 |