| NPI | 1952132565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: Y3765099) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA Y3765099) |
| Enumeration Date | 2024-08-13 |
| Last Update Date | 2024-08-13 |