| NPI | 1215416607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 106S00000X Behavior Technician (Licence: MD RBT-18-71296) | |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2022-03-12 |