NPI | 1720501471 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: VA 1-17-26312) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: VA 0133001495) |
Enumeration Date | 2017-07-24 |
Last Update Date | 2021-02-10 |