| NPI | 1487110151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-23-68797) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL 0-21-13102) |
| Enumeration Date | 2019-02-18 |
| Last Update Date | 2023-10-20 |