| NPI | 1194394247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 5953) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: TX RBT-15-03101) |
| Enumeration Date | 2021-06-23 |
| Last Update Date | 2023-06-30 |