| NPI | 1083017529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: GA 1-21-49013) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: AL 2021-032) |
| Enumeration Date | 2014-09-29 |
| Last Update Date | 2024-03-12 |