| NPI | 1295491371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: AL 1-24-71166) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: AL RBT-17-30719) |
| 106S00000X Behavior Technician (Licence: AL 30719) | |
| Enumeration Date | 2021-11-12 |
| Last Update Date | 2024-03-29 |