| NPI | 1033653498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| 103K00000X Behavior Analyst | |
| Enumeration Date | 2016-12-05 |
| Last Update Date | 2016-12-06 |