| NPI | 1275985608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-19-36280) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-17-37274) |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2019-06-16 |