| NPI | 1407367154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: TX 3899) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2017-10-21 |
| Last Update Date | 2022-10-05 |