| NPI | 1427344886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: VA 0133000969) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: KY 163375) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2022-11-23 |