| NPI | 1316342736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-21-52738) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 106E00000X Assistant Behavior Analyst (Licence: FL 0-17-8208) | |
| Enumeration Date | 2014-10-28 |
| Last Update Date | 2022-04-26 |