| NPI | 1376173435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: UT 14111953-2506) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 1-24-74373) |
| 106S00000X Behavior Technician | |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2020-01-17 |
| Last Update Date | 2024-08-07 |