| NPI | 1700320678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: OH 1-15-21004) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: OH 281) |
| Enumeration Date | 2016-12-13 |
| Last Update Date | 2016-12-13 |