| NPI | 1114434974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CO 1-21-52579) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: CO 0-19-9827) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2018-01-02 |
| Last Update Date | 2023-07-06 |