| NPI | 1720739600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: KY 268643) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: OH 00981) |
| Enumeration Date | 2022-01-12 |
| Last Update Date | 2022-03-28 |