| NPI | 1376080895 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103K00000X Behavior Analyst | 
| Additional Taxonomies | 106S00000X Behavior Technician | 
| 247200000X Technician, Other | |
| Enumeration Date | 2017-01-22 | 
| Last Update Date | 2024-12-27 |