| NPI | 1578198123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: KY RBT-21-176034) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: KY RBT-19-94622) |
| Enumeration Date | 2020-03-04 |
| Last Update Date | 2021-09-23 |