| NPI | 1740733252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: WA CG 60686245) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: WA CG60686245) |
| Enumeration Date | 2016-08-01 |
| Last Update Date | 2016-11-10 |