| NPI | 1427695402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: VA 1-24-74766) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: VA RBT-19-107331) |
| Enumeration Date | 2019-12-09 |
| Last Update Date | 2024-09-17 |