| NPI | 1407407042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CO 1-24-73095) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CO RBT-23-267949) |
| Enumeration Date | 2019-09-25 |
| Last Update Date | 2024-07-15 |