| NPI | 1265108047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: VA 0133002098) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 1-21-52050) |
| Enumeration Date | 2021-08-20 |
| Last Update Date | 2024-05-05 |