| NPI | 1235631466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NV LBA0775) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: WA BA-61192730) |
| Enumeration Date | 2018-03-03 |
| Last Update Date | 2023-07-07 |