NPI | 1760157507 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: VA 0133001905) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
Enumeration Date | 2021-08-13 |
Last Update Date | 2023-06-01 |