| NPI | 1033877337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: TX RBT-21-189738) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: TX 12147062) |
| Enumeration Date | 2021-12-03 |
| Last Update Date | 2021-12-03 |