| NPI | 1033739008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 1-23-68623) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2020-04-20 |
| Last Update Date | 2023-10-03 |