| NPI | 1366899452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW13413) |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2021-08-27 |