| NPI | 1972123263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-21-53382) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: 0-18-9279) |
| Enumeration Date | 2020-04-16 |
| Last Update Date | 2021-09-21 |