| NPI | 1043965437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL K400518963750) |
| Enumeration Date | 2022-02-15 |
| Last Update Date | 2022-03-17 |