| NPI | 1588104442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MI 7401002470) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: VA 0133003665) |
| Enumeration Date | 2017-02-26 |
| Last Update Date | 2024-06-11 |