| NPI | 1932509593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 5054) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 1-21-49249) |
| Enumeration Date | 2014-09-01 |
| Last Update Date | 2024-09-18 |