| NPI | 1811404650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: UT 10772899-2506) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2018-01-02 |
| Last Update Date | 2019-10-07 |