| NPI | 1215339452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MO 2020032797) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: TX 1-08-4225) |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2021-02-25 |