| NPI | 1780386003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: OH 1-23-63799) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: OH COBA.01158) |
| Enumeration Date | 2023-03-20 |
| Last Update Date | 2023-03-20 |