| NPI | 1003425760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 1407596201) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NY 71-P133023-01) |
| Enumeration Date | 2020-07-29 |
| Last Update Date | 2024-12-16 |