| NPI | 1255986352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 1-22-58266) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2019-08-06 |
| Last Update Date | 2022-11-28 |