| NPI | 1497128532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: VA 0133000804) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 103K00000X Behavior Analyst (Licence: VA 0134000068) | |
| Enumeration Date | 2015-11-12 |
| Last Update Date | 2022-02-23 |