| NPI | 1316588338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: OK 1-21-47639) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: OK RBT-19-96898) |
| Enumeration Date | 2019-10-01 |
| Last Update Date | 2022-03-02 |