| NPI | 1992098248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-08-4451) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: AZ BA-29) |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2011-05-19 |