| NPI | 1316678949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: AR 1-23-65596) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: AR RBT-21-183987) |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2023-09-26 |