| 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 |