NPI | 1003364399 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-14-9954) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MI 7401002855) |
103K00000X Behavior Analyst (Licence: TX 2698) | |
Enumeration Date | 2016-09-14 |
Last Update Date | 2025-10-07 |