| NPI | 1477191401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: KY 278031) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-19-102036) |
| Enumeration Date | 2019-12-20 |
| Last Update Date | 2022-06-08 |