| NPI | 1093223166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: VA 0133002053) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: IL 1-17-29037) |
| Enumeration Date | 2018-01-11 |
| Last Update Date | 2024-10-28 |