| NPI | 1013661826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CT BACB560988) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CT 1385) |
| Enumeration Date | 2022-02-10 |
| Last Update Date | 2022-02-10 |