| NPI | 1356850770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MO 2021047070) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: LA 1-17-27952) |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2022-06-14 |