| NPI | 1811363922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: GA 1-22-57786) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-19-75469) |
| Enumeration Date | 2015-08-12 |
| Last Update Date | 2022-06-02 |