| NPI | 1619413028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: UT 10673486-2506) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 106E00000X Assistant Behavior Analyst | |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2023-02-02 |