| NPI | 1265083703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: GA RBT-19-96498) |
| Enumeration Date | 2019-09-25 |
| Last Update Date | 2021-09-21 |