| NPI | 1457907826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: GA 1-23-665558) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: GA 1-23-66558) |
| Enumeration Date | 2019-08-12 |
| Last Update Date | 2024-01-08 |