| NPI | 1598399875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: AR 1-21-56265) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: AR RBT-20-113658) |
| Enumeration Date | 2020-02-26 |
| Last Update Date | 2022-01-11 |