| NPI | 1154857316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TN 1-16-24629) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: AZ BA-0278) |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2021-12-22 |