| NPI | 1255091112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: VA RBT-21-196901) |
| Enumeration Date | 2021-12-20 |
| Last Update Date | 2021-12-20 |