| NPI | 1851661789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MA 1039) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NY 000026) |
| Enumeration Date | 2012-01-10 |
| Last Update Date | 2016-09-21 |