| NPI | 1760839724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-20-45656) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: 0-19-10329) |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2022-04-18 |