| NPI | 1639432859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NY 001165) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY Teacher ID# 2320022) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2024-08-29 |