| NPI | 1669021820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: VA 0134000309) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: VA RBT-19-83448) |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2021-09-21 |