| NPI | 1023571288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: MA 3588) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2022-04-01 |