| NPI | 1265966519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MI 7401001803) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: OR B-10204331) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2023-03-13 |