| NPI | 1275163081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TN 1-22-59981) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-01-21 |
| Last Update Date | 2022-07-27 |