| NPI | 1013631381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 7787) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-20-115216) |
| 106E00000X Assistant Behavior Analyst | |
| Enumeration Date | 2022-09-30 |
| Last Update Date | 2024-12-02 |