| NPI | 1194308486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: PA 1-21-56212) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: PA BH005340) |
| Enumeration Date | 2021-05-04 |
| Last Update Date | 2023-05-09 |