| NPI | 1023511128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: VA 1-22-62973) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: VA 0133002829) |
| 103K00000X Behavior Analyst | |
| Enumeration Date | 2018-03-14 |
| Last Update Date | 2024-03-26 |