| NPI | 1598058570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-22-61620) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL 0-13-5298) |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2022-10-11 |