| NPI | 1689092512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: WA BA60829133) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: WA CG60438404) |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2018-02-26 |