| NPI | 1083172142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-20-44702) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: ND L64) |
| 174400000X Specialist | |
| Enumeration Date | 2019-03-07 |
| Last Update Date | 2022-07-21 |