| NPI | 1043832199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: OH COBA.01016) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: PA 1-20-44106) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2020-05-12 |
| Last Update Date | 2022-08-09 |