| NPI | 1558549956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-05-2569) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: KY 245813) |
| Enumeration Date | 2008-02-07 |
| Last Update Date | 2022-04-06 |