| NPI | 1376137463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 1-23-63501) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-03-01 |
| Last Update Date | 2023-01-23 |