| NPI | 1629794797 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: IL 1629794797) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: IL RBT-21-194869) |
| Enumeration Date | 2022-10-19 |
| Last Update Date | 2025-02-19 |