| NPI | 1487082475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MI 7401000035) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 1-13-12807) |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2023-08-08 |