| NPI | 1821478728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NY 000744-1) |
| Additional Taxonomies | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: NY 021077-1) |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2024-04-11 |