NPI | 1699388645 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-21-56669) |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: CO RBT-19-105318) |
Enumeration Date | 2020-08-28 |
Last Update Date | 2022-06-15 |