| NPI | 1700481827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: AZ BEH-000955) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: AZ RBT-20-141780) |
| Enumeration Date | 2020-12-04 |
| Last Update Date | 2022-08-08 |