| NPI | 1285145920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CO 1-20-45224) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL 0-18-9213) |
| Enumeration Date | 2017-10-20 |
| Last Update Date | 2020-11-08 |