| NPI | 1356873590 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: RI LBA00089) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MA 1606) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2023-10-21 |