| NPI | 1598341968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NJ 1-23-64872) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: NJ RBT-21-153824) |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2023-04-20 |