| NPI | 1689205387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: IN 1-24-76981) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: IN RBT-19-106957) |
| Enumeration Date | 2020-01-31 |
| Last Update Date | 2024-11-13 |