| NPI | 1821744475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: HI BA-549) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 1-21-49448) |
| Enumeration Date | 2022-02-22 |
| Last Update Date | 2022-11-10 |