| NPI | 1821459223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: VA 0133000525) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 1-14-16425) |
| Enumeration Date | 2016-03-11 |
| Last Update Date | 2024-02-06 |