| NPI | 1740504398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-09-5273) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: KY 1-09-5273) |
| 103K00000X Behavior Analyst (Licence: TN 1-09-5273) | |
| 103K00000X Behavior Analyst (Licence: MO 1-09-5273) | |
| 103K00000X Behavior Analyst (Licence: FL 1-09-5273) | |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2023-03-20 |