| NPI | 1376116368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-23-64220) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-21-175965) |
| Enumeration Date | 2021-07-19 |
| Last Update Date | 2023-02-20 |