| NPI | 1407311343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 1-18-34078) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: TX 2685) |
| Enumeration Date | 2019-02-05 |
| Last Update Date | 2023-01-19 |