| NPI | 1790291235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: KY 269653) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 1-20-44756) |
| Enumeration Date | 2017-12-20 |
| Last Update Date | 2023-12-20 |