| NPI | 1285217794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NY BACB474504) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: NY BACB474504) |
| Enumeration Date | 2021-05-03 |
| Last Update Date | 2021-05-03 |