| NPI | 1821672411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MI 7401002566) |
| Additional Taxonomies | 156F00000X Technician/Technologist |
| Enumeration Date | 2021-05-10 |
| Last Update Date | 2024-11-10 |