| NPI | 1558816645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-18-29543) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: NV 0-17-8022) |
| 106S00000X Behavior Technician (Licence: NV RBT1624285) | |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2020-06-22 |