| NPI | 1568126506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-24-70514) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL 0-23-14515) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2021-10-26 |
| Last Update Date | 2024-01-06 |