| NPI | 1780355602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: OK 1-24-75669) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-09-21 |
| Last Update Date | 2024-10-15 |