| NPI | 1184067621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 2403) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 1-10-6834) |
| Enumeration Date | 2013-04-15 |
| Last Update Date | 2023-09-23 |