| NPI | 1992201644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 1971) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: TX 1-18-29586) |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2024-07-19 |