| NPI | 1376093336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MI 7401000567) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst |
| Enumeration Date | 2016-10-13 |
| Last Update Date | 2023-12-11 |