| NPI | 1891213815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-23-68976) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL 0-22-13429) |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2023-10-18 |