| NPI | 1831454057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: HI BA-68) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: TX 0-12-4459) |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2018-09-03 |