| NPI | 1194357376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: AL 2023-047) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: AL RBT-20-111971) |
| Enumeration Date | 2020-02-06 |
| Last Update Date | 2024-04-05 |