| NPI | 1689938375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CO 1-11-8133) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 1118133) |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2021-02-23 |