| NPI | 1194227249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TN 447) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: TN RBT-17-28733) |
| Enumeration Date | 2018-03-05 |
| Last Update Date | 2019-09-30 |