| NPI | 1992069249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 1377) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 1-12-11594) |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2024-12-05 |