| NPI | 1710368022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL 0-21-11844) |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2023-04-12 |