| NPI | 1629504626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NV 1-19-38313) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: NV RBT-17-33627) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2022-11-04 |