| NPI | 1396383030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: IL 1-20-45283) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst |
| Enumeration Date | 2019-12-12 |
| Last Update Date | 2021-08-12 |