| NPI | 1487115580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: CO 12102) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: 1981512) |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2021-12-03 |