| NPI | 1174221501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: RBT-25-436692) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2023-02-15 |
| Last Update Date | 2025-07-15 |