| NPI | 1427535103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: VA 0134000593) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: VA RBT-19-94043) |
| Enumeration Date | 2018-07-25 |
| Last Update Date | 2025-01-15 |