| NPI | 1629520440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 5395) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CO 1-22-61694) |
| Enumeration Date | 2016-10-27 |
| Last Update Date | 2022-12-09 |