| NPI | 1164181343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: 106E0000O) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: NY 106E00000X) |
| 106S00000X Behavior Technician (Licence: NY 106S00000X) | |
| Enumeration Date | 2021-12-15 |
| Last Update Date | 2022-02-22 |