| NPI | 1770934416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: FL 023-14621) |
| Additional Taxonomies | 247200000X |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2023-08-01 |