| NPI | 1215459722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MO 2018045061) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: MO 2017024061) |
| Enumeration Date | 2017-07-17 |
| Last Update Date | 2019-01-07 |