| NPI | 1033766621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: AL 1-22-61306) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: BACB521041) |
| Enumeration Date | 2019-08-20 |
| Last Update Date | 2022-09-07 |