| NPI | 1790384345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: SD RBT-20-132455) |
| Enumeration Date | 2020-10-23 |
| Last Update Date | 2022-08-24 |