| NPI | 1164195517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NC 2038) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 1-13-14242) |
| Enumeration Date | 2021-07-30 |
| Last Update Date | 2024-09-18 |