| NPI | 1558859140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: UT 8644191-2506) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: UT 8644191-2507) |
| 106S00000X Behavior Technician (Licence: UT RBT-18-53305) | |
| Enumeration Date | 2018-04-29 |
| Last Update Date | 2024-07-03 |