| NPI | 1497319925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 5336) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: TX RBT-16-15938) |
| Enumeration Date | 2019-04-30 |
| Last Update Date | 2023-12-19 |