| NPI | 1417520511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 1-22-62482) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: TX RBT-20-137465) |
| Enumeration Date | 2021-07-19 |
| Last Update Date | 2022-11-09 |