NPI | 1518240480 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: PA 1-09-5305) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NJ 1-09-5305) |
Enumeration Date | 2011-09-27 |
Last Update Date | 2011-09-27 |