| NPI | 1134788904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-21-49861) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 19-88633) |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2024-02-13 |