| NPI | 1124697859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NC 1-23-69178) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: NC 11250) |
| Enumeration Date | 2021-06-17 |
| Last Update Date | 2023-11-14 |