| NPI | 1477118677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: SC 1-24-72382) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: SC 0-23-14658) |
| 106S00000X Behavior Technician (Licence: DE RBT-19-84992) | |
| Enumeration Date | 2019-05-03 |
| Last Update Date | 2024-04-16 |