| NPI | 1164809422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: KY 240843) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 0-15-6481) |
| Enumeration Date | 2015-05-06 |
| Last Update Date | 2022-07-12 |