| NPI | 1003347121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: MI 0-20-10814) |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2020-10-28 |