| NPI | 1417579814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: OK 1-22-59481) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-05-08 |
| Last Update Date | 2022-06-10 |