NPI | 1720531916 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-23-66976) |
Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL 0-16-7448) |
Enumeration Date | 2016-07-25 |
Last Update Date | 2024-01-23 |