NPI | 1598256844 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CT 1272) |
Additional Taxonomies | 251S00000X Community/Behavioral Health |
Enumeration Date | 2018-05-22 |
Last Update Date | 2024-04-18 |