NPI | 1043605165 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 0-15-6479) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: WA 61660534) |
Enumeration Date | 2015-04-06 |
Last Update Date | 2025-03-01 |