| NPI | 1205487030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: OR 1-19-38897) |
| Additional Taxonomies | 247200000X Technician, Other (Licence: OR ABA-IN-10202254) |
| Enumeration Date | 2019-09-23 |
| Last Update Date | 2020-03-30 |