| NPI | 1003414194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: OK 1-22-63002) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-10-12 |
| Last Update Date | 2022-12-07 |