| NPI | 1508526690 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: ABA-IN-10217084) | 
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: OR ABA-IN-10217084) | 
| Enumeration Date | 2021-12-30 | 
| Last Update Date | 2022-09-14 |