| NPI | 1548755390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: WA BA70033158) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: WA AB60973210) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2025-11-12 |