| NPI | 1114537230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: VA 0133004115) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: VA 0134000528) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2020-08-04 |
| Last Update Date | 2025-03-12 |