NPI | 1629654116 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NV 1-23-69202) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: UT 1-23-69202) |
Enumeration Date | 2021-03-23 |
Last Update Date | 2025-06-18 |