| NPI | 1558845735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-18-29851) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: WA 60914242) |
| 103K00000X Behavior Analyst (Licence: KS 189) | |
| 103K00000X Behavior Analyst (Licence: MO 2018027335) | |
| Enumeration Date | 2018-09-24 |
| Last Update Date | 2020-08-17 |