| NPI | 1720600661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-17-26986) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: SC WP8917) |
| Enumeration Date | 2020-05-14 |
| Last Update Date | 2020-05-14 |