| NPI | 1528299070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 2391) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: TX 1-10-7183) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-07-31 |
| Last Update Date | 2021-10-18 |