| NPI | 1245705367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NC 1-21-48676) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-10-04 |
| Last Update Date | 2024-03-12 |