| NPI | 1700113735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-14-16577) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 0-08-2622) |
| Enumeration Date | 2009-11-12 |
| Last Update Date | 2021-08-16 |