| NPI | 1669126553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: GA 1-24-77058) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: GA 0-24-14986) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2022-02-09 |
| Last Update Date | 2024-11-13 |