| NPI | 1942368758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: OH P.6283) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: OH 6283) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2024-04-02 |