| NPI | 1275163867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CO 1-22-62210) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: MO RBT-18-70524) |
| Enumeration Date | 2020-01-22 |
| Last Update Date | 2024-01-16 |