| NPI | 1518504836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: OK 1-20-41963) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: OK 15-07340) |
| Enumeration Date | 2019-12-05 |
| Last Update Date | 2020-06-09 |