| NPI | 1124741988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: ND RBT-22-235087) |
| 174400000X Specialist | |
| Enumeration Date | 2022-09-26 |
| Last Update Date | 2025-01-14 |