| NPI | 1528734753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: AZ BEH-001377) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: AZ RBT-19-87690) |
| Enumeration Date | 2021-08-18 |
| Last Update Date | 2024-08-05 |