| NPI | 1043820855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: UT 10382472-2506) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-08-06 |
| Last Update Date | 2023-11-14 |