| NPI | 1417541525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: VA 0133003501) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: VA 0134000475) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2021-03-01 |
| Last Update Date | 2024-05-14 |