| NPI | 1578235230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MI 7401002418APP24) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2021-10-01 |
| Last Update Date | 2025-02-24 |