| NPI | 1851176085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 6476) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: TX RBT-15-07388) |
| Enumeration Date | 2023-08-28 |
| Last Update Date | 2023-12-06 |