| NPI | 1457098790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MO 1-24-76561) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: MO RBT-22-216817) |
| Enumeration Date | 2022-05-18 |
| Last Update Date | 2024-10-17 |