| NPI | 1588141790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-20-46227) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 1-18-8715) |
| Enumeration Date | 2018-07-20 |
| Last Update Date | 2021-07-15 |