| NPI | 1740874668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: GA 1-24-70980) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: GA RBT-21-156920) |
| Enumeration Date | 2021-02-22 |
| Last Update Date | 2024-02-01 |