| NPI | 1851939631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CT 2008) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: OK 1-22-60292) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2019-12-12 |
| Last Update Date | 2024-12-03 |