| NPI | 1437755592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 1-21-47394) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: TX 0-20-11510) |
| Enumeration Date | 2020-12-04 |
| Last Update Date | 2021-02-25 |