| NPI | 1164922241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NC 1191) |
| 103K00000X Behavior Analyst (Licence: CT 887) | |
| Enumeration Date | 2018-02-15 |
| Last Update Date | 2024-01-17 |