| NPI | 1295370658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: IL 1-22-58064) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: IL J620-0009-8152) |
| Enumeration Date | 2019-11-08 |
| Last Update Date | 2024-04-02 |