| NPI | 1083335392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: MO 0-23-14936) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: MO RBT-22-232276) |
| Enumeration Date | 2022-09-06 |
| Last Update Date | 2024-03-15 |