| NPI | 1801514369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 1-23-68881) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NC 2091) |
| Enumeration Date | 2022-08-19 |
| Last Update Date | 2024-10-01 |