| NPI | 1710485354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 1-20-42381) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: TX RBT-17-36085) |
| Enumeration Date | 2018-01-29 |
| Last Update Date | 2023-02-20 |