| NPI | 1003373127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: AL 2021-064) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 106E00000X Assistant Behavior Analyst | |
| Enumeration Date | 2019-02-25 |
| Last Update Date | 2022-06-07 |