| NPI | 1861159121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: VA 0-21-13178) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: VA RBT-21-161513) |
| Enumeration Date | 2021-11-22 |
| Last Update Date | 2021-11-27 |