| NPI | 1578940961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NV LBA0055) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NV 1-14-17117) |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2024-09-17 |