| NPI | 1760940944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: GA RBT-19-76865) |
| Enumeration Date | 2019-03-07 |
| Last Update Date | 2024-02-12 |