| NPI | 1740860915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: IL 1-22-62337) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: IL 152.001310) |
| Enumeration Date | 2021-04-12 |
| Last Update Date | 2025-05-05 |