| NPI | 1548619133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MI 7401000397) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MI 1-19-36187) |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2021-09-03 |