| NPI | 1346678117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-20-43893) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: 0-15-6781) |
| Enumeration Date | 2013-10-14 |
| Last Update Date | 2020-09-21 |