| NPI | 1285304402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NC 1880) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: MA RBT-21-173245) |
| Enumeration Date | 2021-09-18 |
| Last Update Date | 2024-07-29 |