| NPI | 1578029716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NH BACB583443) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MA BACB583443) |
| Enumeration Date | 2019-02-12 |
| Last Update Date | 2023-07-10 |