| NPI | 1396298808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MI 7401000181) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MI 1-17-25546) |
| Enumeration Date | 2016-08-01 |
| Last Update Date | 2024-04-13 |