| NPI | 1750943965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-20-40709) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-17-35060) |
| Enumeration Date | 2019-07-08 |
| Last Update Date | 2020-02-26 |