| NPI | 1407363021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-21-54132) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: OR AB-IN-10178943) |
| Enumeration Date | 2018-01-04 |
| Last Update Date | 2022-11-21 |