| NPI | 1205432739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2020-12-09 |
| Last Update Date | 2024-06-03 |