| NPI | 1104372994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: HI 1-20-45356) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 103K00000X Behavior Analyst (Licence: 1-20-45356) | |
| 106E00000X Assistant Behavior Analyst (Licence: HI 0-19-10060) | |
| 106E00000X Assistant Behavior Analyst | |
| 106S00000X Behavior Technician (Licence: HI RBT-18-71873) | |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2020-10-19 |