| NPI | 1487391017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: 0-22-13613) |
| 106E00000X Assistant Behavior Analyst (Licence: WA LABA.AB.61297640) | |
| Enumeration Date | 2022-05-16 |
| Last Update Date | 2024-07-25 |