| NPI | 1497319529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: KY 274223) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 106S00000X Behavior Technician (Licence: RBT-19-84856) | |
| Enumeration Date | 2019-04-24 |
| Last Update Date | 2021-11-01 |