| NPI | 1124651559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: AR 1-21-53551) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: AR RBT-19-85301) |
| Enumeration Date | 2020-02-13 |
| Last Update Date | 2021-10-05 |