| NPI | 1225605645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NC 385) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 103K00000X Behavior Analyst (Licence: OH 1-20-45137) | |
| Enumeration Date | 2021-06-04 |
| Last Update Date | 2023-09-04 |