| NPI | 1467148320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: WA BA61538806) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: WA CB60954485) |
| Enumeration Date | 2023-04-13 |
| Last Update Date | 2024-03-11 |