| NPI | 1821548645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: WA AB61427616) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: WA CG60703536) |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2023-05-03 |