| NPI | 1669048625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NY 002466) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 1-20-44448) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2021-06-01 |
| Last Update Date | 2023-01-18 |