| 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 |