| NPI | 1497317911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-21-50527) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL 0-18-8847) |
| Enumeration Date | 2019-07-04 |
| Last Update Date | 2021-07-08 |