| NPI | 1801905815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: WA LH60018127) |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2010-07-22 |