| NPI | 1831545847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: GA 1-15-21249) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 103K00000X Behavior Analyst (Licence: CA 1-15-21249) | |
| Enumeration Date | 2016-05-09 |
| Last Update Date | 2018-08-20 |