| NPI | 1780271668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NY 000336) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NY 336) |
| Enumeration Date | 2020-12-28 |
| Last Update Date | 2023-07-03 |