| NPI | 1811556491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: CO RBT-19-88892) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CO 19-88892) |
| Enumeration Date | 2019-06-07 |
| Last Update Date | 2020-12-16 |