| NPI | 1548501760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-15-21146) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA BCaBA: 0-13-5382) |
| Enumeration Date | 2013-03-13 |
| Last Update Date | 2020-02-21 |