| NPI | 1679268759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: CO bacb650671) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CO bacb650671) |
| Enumeration Date | 2023-04-05 |
| Last Update Date | 2023-04-06 |