| NPI | 1801415393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: GA 1-22-60214) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: GA RBT-18-60097) |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2022-07-02 |