| NPI | 1174000376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: KY 290025) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 103K00000X Behavior Analyst (Licence: TX 3327) | |
| Enumeration Date | 2018-07-20 |
| Last Update Date | 2024-05-23 |