| NPI | 1568887974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: FL 0-19-9742) |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2014-02-20 |
| Last Update Date | 2021-05-03 |