| NPI | 1629682828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: RI 00355) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MA 3211-MH-B1) |
| 103K00000X Behavior Analyst | |
| Enumeration Date | 2020-09-04 |
| Last Update Date | 2023-07-10 |