| NPI | 1205336930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MS 180045) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: TN 1217) |
| 103K00000X Behavior Analyst (Licence: AL 2022-550) | |
| Enumeration Date | 2018-02-19 |
| Last Update Date | 2023-05-03 |