| NPI | 1003264672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MI 7401001048) |
| Additional Taxonomies | 247200000X Technician, Other (Licence: MI Z000475460762) |
| 103K00000X Behavior Analyst | |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2022-08-18 |