| NPI | 1710422464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: GA 1-16-24244) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: IL 1-16-24244) |
| Enumeration Date | 2017-01-04 |
| Last Update Date | 2024-01-23 |