| NPI | 1821740580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-01-24 |
| Last Update Date | 2022-04-29 |