| NPI | 1497094700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: VT 11210175) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: VT 146.0120230) |
| Enumeration Date | 2013-02-06 |
| Last Update Date | 2023-01-05 |