| NPI | 1528208618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: WI 19-140) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 1-05-2453) |
| Enumeration Date | 2009-03-02 |
| Last Update Date | 2011-11-01 |