| NPI | 1467984005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 1-17-25582) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NC 2130) |
| Enumeration Date | 2017-04-02 |
| Last Update Date | 2024-10-23 |