| NPI | 1013594530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: CO RBT-21-161832) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CO 1-25-85219) |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2025-10-28 |