| NPI | 1609951755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NY 002778) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2024-07-30 |