| NPI | 1710307475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NJ 1-15-20785) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 876960) |
| 103K00000X Behavior Analyst (Licence: NY 001212) | |
| Enumeration Date | 2014-04-21 |
| Last Update Date | 2021-03-16 |