| NPI | 1801303326 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NV LBA0311)  | 
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: NV RBT-17-40411)  | 
| 106S00000X Behavior Technician (Licence: NV BACB388383)  | |
| Enumeration Date | 2018-01-05 | 
| Last Update Date | 2020-10-27 |