| NPI | 1669014247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: KS 00540) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MO 2022021470) |
| Enumeration Date | 2019-10-15 |
| Last Update Date | 2024-12-16 |