| NPI | 1871186403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: FL 0-21-12156) |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2021-02-15 |
| Last Update Date | 2022-03-07 |