| NPI | 1457823270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: GA BACB471524) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-18-73646) |
| Enumeration Date | 2018-12-18 |
| Last Update Date | 2022-10-28 |