| NPI | 1104420025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: MO 2020036420) |
| Enumeration Date | 2020-11-23 |
| Last Update Date | 2022-11-04 |