| NPI | 1528303583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: HI 1-17-25047) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA BCaBA: 0-10-3947) |
| Enumeration Date | 2012-12-03 |
| Last Update Date | 2020-11-03 |