| NPI | 1144848334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: TX 4490) |
| 106S00000X Behavior Technician (Licence: TX RBT-19-97668) | |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2024-01-17 |