| NPI | 1356033807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MA 1-24-73812) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: MA 0-24-15077) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2023-05-23 |
| Last Update Date | 2024-06-25 |