| NPI | 1336412915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: TX 3435) |
| 103K00000X Behavior Analyst (Licence: CA 1-18-32500) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-02-13 |
| Last Update Date | 2024-10-17 |