| NPI | 1134584865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: WA BA61057756) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: WA RBT-15-01871) |
| Enumeration Date | 2015-12-22 |
| Last Update Date | 2024-08-27 |