| NPI | 1508354929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-22-60328) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-16-15020) |
| 106E00000X Assistant Behavior Analyst (Licence: 0-18-9293) | |
| Enumeration Date | 2018-05-01 |
| Last Update Date | 2022-07-07 |