| NPI | 1477121754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: OR 10211838) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: OR 10211838) |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2021-06-21 |