| NPI | 1396352209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: GA 1-22-62962) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: GA RBT-20-126918) |
| Enumeration Date | 2020-09-24 |
| Last Update Date | 2022-12-02 |