| NPI | 1003263930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL BCBA-1-21-53843) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL 0-18-8479) |
| Enumeration Date | 2016-05-20 |
| Last Update Date | 2021-10-26 |