| NPI | 1326698788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: AL 1-20-43293) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-19-99002) |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2020-11-29 |