| NPI | 1508536418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: IN 1-22-57664) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: IN RBT-21-184787) |
| Enumeration Date | 2021-09-14 |
| Last Update Date | 2022-02-03 |