| NPI | 1437715109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MO 2021001427) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: IN 1-19-39517) |
| 106S00000X Behavior Technician (Licence: IL RBT-16-25272) | |
| Enumeration Date | 2019-05-17 |
| Last Update Date | 2024-04-26 |