| NPI | 1578031092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 5764) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: TX 1744299) |
| Enumeration Date | 2018-11-02 |
| Last Update Date | 2024-04-14 |