| NPI | 1578827515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CT 1-21-51123) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 640601121) |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2022-05-09 |