| NPI | 1578600383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 1-02-0994) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: TX 1048) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2022-10-19 |