| NPI | 1780048223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: WA BA60772332) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: TX 1-16-22030) |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2024-03-13 |