| NPI | 1316504210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CO 1-20-40921) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CO RBT-18-50464) |
| Enumeration Date | 2019-05-26 |
| Last Update Date | 2022-02-23 |